Cigna Sleep Study Precertification Request Form 2013-2025 free printable template

SLEEP STUDY PRECERTIFICATION REQUEST FORM cigna.sleepccx. com Phone 877. 877. 9899 Fax 866. 536. 5225 This form must be completed in its entirety for all faxed sleep services precertification requests. The most recent clinical notes must also accompany the faxed request. We recommend that all requests for sleep related services are submitted via our website at cigna*sleepccx. com* If the Cigna ID card shows S under the member name or next to the CIGNA logo the provider must call the number on...

How to fill out sleep form print

How to fill out Cigna Sleep Study Precertification Request Form

1. Obtain the Cigna Sleep Study Precertification Request Form from the Cigna website or your healthcare provider.
2. Fill out your personal information at the top of the form, including your name, date of birth, and member ID.
3. Provide the details of the referring physician, including their name, contact information, and NPI number.
4. Indicate the type of sleep study requested (e.g., in-lab sleep study or home sleep apnea test).
5. Complete the section detailing the patient's medical history, including relevant symptoms and previous treatments.
6. Attach any necessary supporting documentation, such as medical records or test results.
7. Review the form for completeness and accuracy before submission.
8. Submit the completed form to Cigna via fax, mail, or through the Cigna provider portal, as per the instructions.

Who needs Cigna Sleep Study Precertification Request Form?

1. Patients who are experiencing symptoms of sleep disorders, such as insomnia or sleep apnea.
2. Healthcare providers referring patients for sleep studies to assess or diagnose sleep-related conditions.
3. Individuals seeking insurance coverage for sleep studies with Cigna.

Video instructions and help with filling out and completing sleep study form online

Instructions and Help about sleep study form pdf

Hi IN#39’m Kevin Wade I'm a senior therapist at the st. John Clark pain treatment center, and I'm the Campus Director at the Center for euro match studies both of our organizations are a bunch of very passionate people trying to educate you about euro somatic therapy and the benefits to you and your health and your pain and anything else we can bring to you today IN#39’m going to have a little discussion with you about sleeping one of my favorite things in the world to debut really honestly it#39’s not the favorite thing of a lot of people because they're uncomfortable when they sleep one of the questions we get asked most often in the clinic is you know what about my bed what about my pillow what about my sleeping position it'actually one of the questions we asked on our intake form what position do you usually sleep in and so there we believe there are some things that are really important about sleeping position, and I'm going to share with you today what we feel at the clinic are the two best positions to sleep in kind of your basics sleeping positions and IN#39’m going to share one with you that is not so good for anybody so without further avoid#39’m going to get a couple of examplespherere and we#39’ll take a look at these positions okay so let#39’s start with how not to sleep I'm going to go out on climb and say pretty universally stomach sleeping is a bad idea for everybody adhere#39’s why most people sleep on their stomach with a pillow sometimes flat on it on the bed butthead#39’s even not that much better so what we're doing is we#39’re putting the spine into a little of an extension and tightening down all of these muscles that are coming down the back along with that we can see that Levi here has her head turned to the side and if we#39;redoing to sleep on our stomach we have to turn our head to the side that puts our cervical spine into rotation into a twist, and then we stay there for hours and hours when we#39;resleeping the other thing that we end unseeing with stomach sleepers — again depending on the mattress and testate of the mattress is that the low back tends to curve too much here — kind of sinks into the bed, and we end upsetting some low back issues there are variations of what happened down here people with their feet sometimes straight out sometimes kicked to the side here now we#39’re putting the hip into a shortened kind of position and very asymmetrical here as Alexis#39’s trying to sleep the worst Prof thesis sleeping position is what happen sin the cervical spine and that's that rotation in the clinic we treat Atlas access distortions MAL positioning of those structures by releasing the muscles around them and when you're in this twist and most people tend to turn their head to the same side every time they sleep on their stomach it's notlike they switch back and forth which would make it better, but it's still not great, so we get we'd start to develop these rotations in the cervical spine that tend to go to...

People Also Ask about sleep study request

How do you write a referral for a sleep study?

* Referral notes or forms should include: Patient name, date of birth, sex, address and phone number. Referring provider's name, address and phone number. Diagnosis or reason for referral. Department patient is being referred to. Most recent chart notes supporting the diagnosis or reason for referral.

What diagnosis qualifies for sleep study?

Conditions that a sleep study can diagnose include: Sleep apnea (obstructive and central). Narcolepsy. Periodic limb movement disorder (including restless legs syndrome).

How do you prove sleep apnea to the VA?

NOTE: The diagnosis of sleep apnea must be confirmed by a sleep study; provide sleep study results in Diagnostic testing section. If other respiratory condition is diagnosed, complete the Respiratory and / or Narcolepsy Questionnaire(s), in lieu of this one.

Do you need a script for a sleep study?

However, they typically require a referral from a patient's primary care provider (PCP). If you already have a well-established relationship with your PCP, simply make an appointment with them and let them know about your sleep problems. Explicitly state that you would like to undergo a sleep test.

Can I request a sleep study from the VA?

The VA can arrange for your to receive a medical exam to review your symptoms of insomnia. This exam is officially called a Compensation and Pension (C&P) exam and will likely take place at a VA clinic. During this exam, the doctor will investigate your symptoms and try to determine the root cause of your insomnia.

How do I ask the VA for a sleep study?

How do I get a sleep study with the VA? Check the VA website for resources. Call your local VA hospital and ask if they have a sleep clinic. Talk to your primary care physician or mental health care provider and ask if they know of any VA sleep centers in your area.

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What is Cigna Sleep Study Precertification Request Form?

The Cigna Sleep Study Precertification Request Form is a document used by healthcare providers to request prior authorization from Cigna for sleep studies that are to be performed on patients.

Who is required to file Cigna Sleep Study Precertification Request Form?

Healthcare providers or clinicians who are arranging a sleep study for a patient covered under a Cigna health plan are required to file the Cigna Sleep Study Precertification Request Form.

How to fill out Cigna Sleep Study Precertification Request Form?

To fill out the form, providers must complete sections with patient information, details of the requested sleep study, clinical indications, and supporting medical history relevant to the request.

What is the purpose of Cigna Sleep Study Precertification Request Form?

The purpose of the form is to ensure that the sleep study is medically necessary and meets Cigna's coverage criteria before it is conducted, thus streamlining the authorization process.

What information must be reported on Cigna Sleep Study Precertification Request Form?

The form must include the patient's demographic information, insurance details, the type of sleep study requested, the reasons for the study, relevant medical history, and any prior treatments or diagnoses related to sleep disorders.